Case Report
Volume 8 Issue 8 - 2021
A Rare Case of Spontaneous Calcific Cerebral Embolization Revealing a Calcified Rheumatic Mitral Stenosis: Case Report
Meryem Haboub*, S Abouradi, H Mechal, G Minko, A Moukhliss, S Arous, Meg Benouna, A Drighil, L Azzouzi and R Habbal
Cardiology Department, Hospital University Ibn Rochd, Casablanca, Morocco
*Corresponding Author: Meryem Haboub, Cardiology Department, Hospital University Ibn Rochd, Casablanca, Morocco.
Received: July 08, 2021; Published: August 16, 2021




Abstract

Background: Cerebral cardiac embolism accounts for an increasing proportion of ischemic strokes and transient ischemic attacks. Calcific cerebral emboli are rare and mostly iatrogenic secondary to heart or aorta catheterization. However, spontaneous cerebral calcific embolism in the case of calcific aortic valve is very rare and there are less than 10 case reports in the literature. And more interesting fact, such an event in the context of calcific mitral valve disease has never been reported, at least to our knowledge. We are reporting a case of spontaneous calcific cerebral embolism revealing a calcified rheumatic mitral valve stenosis.

Case Presentation: We report a case of a 59 year-old-patient, with a history of rheumatic fever at the age of 14 and no history of recent cardiac intervention or aortic/carotid manipulation, admitted to the Emergency Department after a transient ischemic attack. Physical examination at admission found normal BP at 124/79 mmHg, HR at 90 bpm. 12-lead ECG showed an atrial fibrillation, no other anomalies. Unenhanced cerebral CT imaging was performed, revealing calcific material inside both middle cerebral arteries. Transthoracic echocardiography was performed, showing severe mitral leaflets calcification with a severe mitral stenosis, probably due to rheumatic heart disease. Cervical arteries Duplex was normal. A vitamin K antagonist (acenocoumarol) was prescribed, targeting an INR of 2 - 3 and mitral valve replacement surgery was performed using mechanical prosthesis. Short and long term with a 1-year follow-up were good and patient didn’t experience any stroke.

Conclusion: Spontaneous calcified cerebral emboli secondary to mitral valve leaflets calcifications is a n extremely rare condition. Replacement of the valve is the only option to prevent recurrent emboli and outcomes are still to be determined.

Keywords: Spontaneous Calcific Cerebral Emboli; Transient Ischemic Attack; Mitral Leaflet Calcification; Rheumatic Mitral Stenosis; Mitral Stenosis

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Citation: Meryem Haboub., et al. "A Rare Case of Spontaneous Calcific Cerebral Embolization Revealing a Calcified Rheumatic Mitral Stenosis: Case Report”. EC Cardiology 8.9 (2021): 01-06.

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